Menstrual abnormalities in school going girls - are they related to dietary and exercise pattern?

CONTEXT

Adolescence is the transitional phase of physical and mental development between childhood and adulthood and is characterized by immense hormonal changes.75% of girls experience some problems associated with menstruation.

AIM

We tried to find out the prevalence of menstrual abnormalities in school going girls in Pondicherry and their association with dietary and exercise habits.

SETTING AND DESIGN

A cross-sectional questionnaire based study was conducted in adolescent girls who attained menarche in four secondary schools of Pondicherry, India.

MATERIAL AND METHODS

All students who attained menarche and willing to participate in the study were invited to answer the questionnaire, which dealt with anthropometric data, socioeconomic data, menstrual history, and diet and exercise pattern.

STATISTICAL ANALYSIS

Chi-square test and Fisher's exact test was used to compare the dietary and exercise patterns among students having menstrual abnormalities and those who do not have menstrual abnormalities.

RESULTS

A total of 853 students participated in the study. Dysmenorrhea and premenstrual symptoms were the most frequent problems encountered. Premenstrual symptoms were significantly more common among girls who were overweight, in girls who were eating junk food regularly, in girls who were eating less food (dieting) in order to lose weight and in those who were not doing regular physical activity. Dysmenorrhea was significantly more common in the girls who were dieting to lose weight. Passage of clots was also significantly high in the girls who were dieting.

CONCLUSION

Lifestyle modifications like regular physical activity, decreasing the intake of junk food and promoting healthy eating habits should be emphasised in school health education programs to improve their menstrual health.

Fertility outcome after reversal of sterilization

OBJECTIVE

The study was designed to evaluate the fertility outcome in sterilization reversals and a variety of factors that have been suggested to influence the successful outcome of sterilization reversal procedures.

METHOD

It is a retrospective study involving all sterilization reversals performed between January 1991 and December 1995 in our hospital. A total of 58 cases were treated. Tubal anastomosis was performed according to rules of microsurgery. The loupe microsurgical technique with 4 x magnification comprising two main phases, preparation of healthy tubal segments and anastomosis carried out in two layers.

RESULTS

It was possible to study subsequent fertility of 50 patients in all, as 8 patients were lost to follow-up (13.76%). The overall conception rate was 68% (34 cases), out of which intrauterine pregnancy rate was 62% (31 cases), ectopic pregnancy rate was 6% and the abortion rate was 6%. Fifty percent of patients conceived within first 12 months of reversal of sterilization. The isthmic-isthmic type of anastomosis has maximum incidence of pregnancies (88.88%).

CONCLUSION

Laparoscopic (Falope ring) sterilization should be preferred in women who are willing for interval sterilization and it should be done at isthmic segment of the tube, whereas the Pomeroy's method is to be reserved for occasional postpartum procedure. Reversal of sterilization should be done with strict adherence to principles of microsurgery.

Perinatal outcome in relation to mode of delivery in meconium stained amniotic fluid

Meconium staining of the amniotic fluid is a common complication during labour. When facilities like electronic monitoring, foetal blood sampling are not available, it is difficult to decide whether labour should be allowed to continue or caesarean section should be done. Even when caesarean section is done, meconium aspiration syndrome (MAS) can still occur and considerable morbidity and mortality may result in the newborn. Amino infusion is being considered as useful in decreasing MAS and its sequelae. Before resorting to amino infusion, we decided to analyse the perinatal outcome in meconium stained liquor to compare whether early caesarean section offered any advantage. This is a retrospective study of 150 labours complicated by thick meconium stained liquor, during a 12 month period (1992-93).

Two cases of gas gangrene complicating uterine rupture and fetal death at term

Two patients with obstructed labor and uterine rupture complicated by clostridial septicemia are reported. The diagnosis was apparent clinically. The importance of early diagnosis and prompt treatment are emphasized. The place of hysterectomy, which should be individualized is discussed. All efforts should be directed towards prophylaxis in high risk cases.

Internal iliac artery ligation in obstetrics and gynecology. Ten years experience

Twenty-two cases of bilateral internal iliac artery ligation done in the Department of Obstetrics and Gynecology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India over a period of 10 years (1981-1990) were studied. Various indications and complications were analysed. Internal iliac artery ligation is a life-saving procedure in pelvic hemorrhage. Complications are infrequents.